Arthritis of the acromio-clavicular joint (A-C joint) arises after long term heavy use of the shoulder or after previous injury causing a dislocation of the joint.
When the arthritis produces pain and weakness that have not responded to physiotherapy and home exercises, the pain can be relieved and the shoulder function can be improved with surgical removal of the outer end of the clavicle.
It is good to maintain a full passive range of motion of your shoulder because this improves the rate of recovery of motion after surgery. You will need about two weeks off work if you have a physical occupation so it would be best to have any time away from work organised before surgery.
The outer end of the clavicle is exposed through the top of the clavicle and once the joint has been identified about 8 mm are removed and the bone reshaped to produce a normal contour of the shoulder and ensuring no contact occurs between the clavicle end and the acromion. The capsule is repaired to maintain stability of the joint.
You will be able to go home on the day of surgery as good pain control is established with local anaesthetic infiltration. You will be resting in a sling for about two weeks but you will start physiotherapy early to regain passive movements in the shoulder joint. Regaining movement helps to reduce pain as well. Active resistive training can commence about two weeks post-operative and how quickly you progress depends on how much training you can undertake at home.
The usual operative risks exist as for any shoulder surgery including blood clots, wound infection and failure of the repair to heal requiring repeat surgery. Such problems are quite rare. You may also develop stiffness of the shoulder due to adhesions binding up the joint and for this a manipulation under anaesthesia may be required.
Before surgery is recommended, you will have had physiotherapy to improve the strength of the shoulder and if your pain is mild and power recovery good, surgery would not be required. Only if pain is troublesome and power recovery is inadequate will we recommend surgery.